October 20, 2006

Many of you probably already know Ann Douglas. She is the acclaimed author of several best-selling parenting books, including "The Mother of All Pregnancy Books" and "The Mother of All Baby Books," and has recently published a new book on a favorite topic of parents –- SLEEP!

The first few sentences of Ann's latest book, "Sleep Solutions for Your Baby, Toddler, and Preschooler," say it all. "Sleep is a lot like sex. If you're not getting it as much as you'd like, it can become a bit of an obsession. Suddenly, all you can think about is when you last had it, how great it felt when you had it, and what you can do to get some again."

What is so unique about Douglas' book is that it doesn't just give parents an agenda for how to fix sleep issues, but it also addresses how weary moms and dads can cope with sleep deprivation until their children are sleeping better. Its parent-centered focus removes the shame and guilt often associated with children who either fight going to sleep or wake up several times a night. As a former member of the Sleep Deprivation Club, I was only too eager to talk with Douglas about her new book.

Anjali: You've written many popular books on parenting. What made you decide to write a book on sleep issues?

Ann: I've been really frustrated by the way the sleep debate has become so polarized in the past, specifically, how choices have become so black and white and how parents have been made to feel so guilty for choosing one sleep option. Just as we've seen babies who sleep well described as "good babies" we've seen parents who fall into a particular sleep training camp judged as "good parents."

Fortunately, I think the really nasty you're-either-with-us-or-you're-against-us thinking about sleep reached its peak about a year ago. That's when Doctors Sears and Ferber began to state publicly what parents have known forever: there's no one-size-fits-all sleep solution. Even the best conceived sleep plans in the world can get messed up a little when real parents and real babies arrive on the scene.

Anjali: What type of sleep issues did you confront with your own four children? Did you try any of the more well-known sleep techniques?

Ann: My firstborn was colicky and she would be so worn out after an evening of marathon crying that, starting from the time she was around three weeks of age, she would sleep through the night (from midnight until 5:30 a.m. or 6:00 a.m.) by the time she went to bed. I was pretty exhausted, too, after spending the previous seven or eight hours walking the floor with her and otherwise trying to soothe her.

The next two babies didn't have particularly noteworthy sleep patterns. In fact, they pretty much followed the "baby sleep book rules" for average sleepers. They would take some daytime naps, sometimes wake in the night, and then at some point during the second half of year one, they started sleeping through the night. Of course, they didn't always sleep through the night. If they were sick, lonely, scared, etc., all bets were off in the sleeping department. That's my definition of "normal."

My youngest took the longest to sleep through the night. I think there were a few factors at play here. For one thing, he has always had a super sensitive temperament and is an extremely restless sleeper to this day. While not getting a solid night's sleep for two and a half years was quite exhausting, I feel fortunate that he was a pretty businesslike night-waker, in that he got up in the night, nursed, and then fell asleep beside me. When he was very young, he slept in our bed. As he got older, he slept in a crib in our room, and I'd transplant him back to his own bed after he fell asleep after nursing. Obviously, every parent has to make their own decisions about what sleeping arrangements will work best for them and their family, taking into account the most current sleep safety recommendations.

In terms of sleep-training with my own kids, I tended to lean toward a "let's wait and see if this is just a developmental stage" approach to a lot of sleep issues. In other words, I did my research to find out if suddenly getting up in the night after a period of previously sleeping through the night was "typical" behavior for an older baby (it was). I then compared notes with other moms to find out how long this stage lasted in their kids and how they stayed sane when they had to cope with sleep deprivation once again after having a period of uninterrupted sleep.

Then, based on what I knew about my child, I'd decide for myself whether or not we actually had a sleep problem or if I just needed to be patient a little while longer while my child worked through this phase. If we did have a sleep problem, I’d decide which sleep training approach was likely to work best with this particular child. When they were babies, I always used sleep-training methods that minimized crying and emphasized soothing and parent presence, but as they moved into the toddler years, I was able to give my kids a little more opportunity to experience more frustration as part of the sleep learning process, even if this meant that they were experiencing some protest crying. I felt that this was developmentally appropriate.

Anjali: When do you know your child has a sleep problem?

Ann: Tune into the signs of sleepiness vs. overtiredness in your child. There are generic signs that are typical to most babies and young children, such as, being less active, staring into space, getting that reddish look around the eyes followed by yawning and the actual watering of the eyes. You may find that your child has some special mannerisms like twirling his hair around his finger, sucking his thumb, and tapping one leg on the floor, that clue you into the fact that he's about to move from tired to overtired territory and you'd better seize the moment if you want to get him settled down to sleep before he gets totally wired for sound.

Anjali: What are some of the biggest sleep issues that parents grapple with?

Ann: There are so many sleep issues that parents grapple with, including babies and toddlers who don't want to go to sleep or stay asleep, babies and toddlers who get up at the crack of dawn (or earlier), babies and toddlers who are cat-nappers or who won't nap at all. I feel like I'm taking you on a guided tour of some Sleep Deprivation House of Horrors!

And then there are all the ways that sleep deprivation affects life as a parent, such as fuzzy thinking, heightened emotionality, a greater likelihood of fighting with your partner, a sex life that may have gone AWOL, increased odds of falling asleep at the wheel, difficulty solving problems (including your child's sleep problems), increased susceptibility to postpartum depression (there's a link between sleep deprivation and PPD), and increased susceptibility to illness. These are things that most sleep books don't address or, if they do, they only address them in passing. I put these issues at the forefront by talking about them in the first two chapters of my book. I wanted to write the world's first sleep solutions book that truly took into account the needs of the sleep deprived mother and her partner.

Anjali: When compiling research for the book, did you have any trouble finding parents who were open and honest about their children's bad sleep habits?

Ann: Not at all! The parents I interviewed were brutally honest. They told me how sleep deprivation had impacted on their enjoyment of parenting and their relationships with their partners. They told me how the guilt that has been injected into the sleep training debate in recent years made them second guess their parenting decisions, and how they worried that they had let their babies down because of something they had or hadn't done on the sleep front.

Anjali: As you point out in your book, it's such a taboo topic to talk about sleep issues with toddlers or preschoolers. Why do you think this is?

Ann: The myth that "all babies" will be sleeping through the night by age six weeks, age three months, age six months, or age one year has been incredibly well perpetuated. Everyone seems to have bought into one of these myths except, of course, for the babies. Feeling like everyone else's toddler or preschooler is sleeping through the night (which, of course, is not true) makes it really difficult to talk about the sleep problems that are making nighttimes difficult at your house. It's easy to start to feel like there's either something wrong with your child or you've failed as a parent. Most parents shut down and stop telling the truth about sleep, except to a handful of trusted confidantes, such as other moms and dads who have done their own time in the sleep deprivation trenches and who can be trusted not to judge or offer painfully simplistic advice.

Anjali: What practical tips can you give tired and weary parents who can barely make it through the day, and see no end in sight to their children's sleepless nights?

Ann: Ask a well-rested friend to help you to come up with a game-plan that will allow you to get more sleep, and identify strategies for boosting your energy level so that you can feel better physically until you are getting more sleep.

Here are a couple of tips from the book, particularly Chapter 2.

1. Ask someone you trust to take care of your baby right after you nurse so that you can nap until the next feeding; or take care of your other children so that you can take your baby to bed, nurse in the side-lying position and rest; or offer a bottle of expressed breast-milk to your baby so that you can sleep through one of the late evening feedings and get a solid block of nighttime sleep. Also, have someone assist with laundry, chores, or errands so you can relax or nap when baby is sleeping.

2. Simplify and streamline nighttime parenting by having the necessary supplies at hand. Only change your baby in the night when it's necessary.

4. Exercise for energy. Choose a mom-friendly fitness routine that is sustainable and realistic. You want your workout to be stress-reducing, not stress-inducing.

5. Seek out the support of other moms.

6. Be on the lookout for the warning signs of postpartum depression, and make sure that friends and family members are alert to the warning signs, too.

Anjali: I remember when my own children were sleeping so badly, I felt such pressure from friends and family members to get them to sleep better. Do you think society puts too much pressure on parents of very young children to form “good” sleep habits? If so, why do you think this is?

Ann: We live in a quick fix society so it's hardly surprising that those around us want to provide us with quick-fix solutions when they see us struggling, even when, in the case of the world of babies, quick-fix solutions conspire against the natural rhythms of mothers and babies.

What makes it tougher is that the sleep advice comes at you from all directions. Well-meaning family members are quick to pass along a lead about a new sleep training method they heard about on an afternoon talk show or in the evening newspaper, without knowing if the sleep training method described is right for you or your baby. It can be frustrating to deal with the flood of unsolicited and often conflicting advice about sleep, particularly when you're completely sleep-deprived and feeling emotionally fried.

Anjali: In what ways do you think parents run into difficulty when they try to get their children to sleep better?

Ann: First of all, I think parents really run into difficulty trying to be so loving and nurturing to their baby or toddler that they don't know how to allow sleep learning to take place.

Learning to sleep through the night is a skill like any other type of skill. It seems to happen easily and naturally for some kids. For other kids, it's a much more difficult skill to learn and, like learning to ride a bicycle, some frustration may be involved. The key is being able to know when your baby or toddler is ready to start learning this skill. If you start too soon, your child may experience a lot of added frustration. But if you don't ever allow him to practice his "sleeping through the night skills" and he hasn't picked up those skills on his own, he may end up being totally dependent on you to help him get back to sleep every time he wakes up in the night for many years to come. That's not a great thing for him or for you.

Secondly, I think parents sometimes overlook the fact that they are the true experts when it comes to solving their child's sleep problems.

Anjali: Another issue you address in your book, which is I found lacking in other sleep books, is the issue of resentment that builds against your partner when the entire family is so overtired. What can parents do to ease the frustration caused by having a bad sleeper?

Ann: My advice is to talk to your partner, and then talk some more. If you’re not too tired, you might even consider having the new parent equivalent of a hot date (cuddling and playing “pass the baby” while you watch a movie, and hoping that you’ll be able to squeeze in romance and/or a nap in between feedings). Keeping your sense of humor helps a lot, too, in terms of staying connected with your partner.

Anjali: Where else can parents look if they want to find out more about sleep issues with their children?

"Sleep Solutions for Your Baby, Toddler and Preschooler" was provided free to DotMoms for review and is available from Amazon.com. This interview took place via e-mail and was edited for space and clarity.

Anjali resides with her family in suburban Philadelphia and is still traumatized by the sleep deprivation once inflicted by her two young girls.